Angioplasty is a nonsurgical procedure to open blocked or narrowed coronary arteries. Also called percutaneous coronary intervention (PCI) or balloon angioplasty, it is used to treat severely blocked coronary arteries as well as arteries diseased with atherosclerotic plaque in other parts of the body. The procedure involves threading a catheter with an inflatable balloon-like tip through the artery to the area of blockage. The balloon is inflated, flattening the fatty deposits and widening the arterial channel, allowing more blood to reach the heart muscle. The doctor may insert a small mesh tube called a stent to keep the artery open and prevent future blockages.
Angioplasty offers several advantages:
- The operation is performed under local anesthesia.
- Although invasive, it does not involve surgery or the use of a heart-lung machine.
- It is not as costly as coronary bypass surgery, nor does it involve more than 1 or 2 days of hospitalization under ordinary circumstances.
Angioplasty is not appropriate for all types of coronary artery disease, nor does it work in all people. For example, studies show that women are not as likely as men to benefit from the operation; they also have a higher mortality rate from the procedure. Some studies have put the success rate at about 60 percent; people who undergo an unsuccessful angioplasty still may require coronary bypass surgery. As technology advances, the applicability and success rates of angioplasty may improve. It also should be noted that it is not a cure for the disease. In a significant number of patients, the occlusions recur, and a repeat angioplasty may be required after 2 or 3 years.
Angioplasty is also used to treat blockages in the arteries of the legs and the carotid artery, the major vessel carrying blood to the brain.
A variation of balloon angioplasty uses a tiny drill-like device to shave away fatty deposits, similar to a Roto-Rooter. Another still experimental, variation called laser ablation, is performed through a special viewing tube (fiber-optic catheter) that is inserted into the clogged artery. A laser, an intense beam of light, is used to vaporize the plaque.